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To
To
>> New
Specialty
pharmaceuticals expenditures in
the U.S. approached $100 billion in 2010, and
are expected to increase at a rate of 12% to
15% annually.
>> New
pharmacy models and data requirements are beginning to emerge from the
macro changes occurring in the healthcare
arena.
% Drug Spend
28%
24%
20%
16%
12%
8%
4%
0%
-4%
2006
2007
2008
2009
2010
2011
2012
2013
2014
Figure 1
Stage
Quick Take
Stage
Physician Office
Starter Rx (free)
is delivered to
patient within
four days.
Copay
Assistance
Welcome to
BRAND A
from SC Nurse
Specialty
Dist. of Paid Rx
Ongoing
nurse follow-ups
SC communicates
benefits to patient.
Treatment form
(incl. starter Rx)
sent to support
center (SC).
Std. (Paid) Rx
sent monthly by SP.
Patient Home
Patient Home
HUB
Inquires if patient
is in need of
assistance.
Patient Home
HUB
Foundation
Specialty
Pharmacy
Figure 2
N = Avg. # of Days
HUB in Progress
Enrollment in
Non-Foundation
Enrollment in
Foundation
Currently Pending
Foundation
Approval
Active
Foundation
Enrollment/ Cancelled/
Triaged to
Pending Discontinued Specialty Pharmacy
Enrollment/ Cancelled/
Triaged to
Pending Discontinued Specialty Pharmacy
Active
Enrollment to Triage to SP
Specialty Pharmacy
N
Enrollment
Pending
Active
Cancelled/
Discontinued
Enrollment
Pending
Currently
Enrolled
Currently
Enrolled
Moved to
Cancelled
Active
Cancelled/
Discontinued
N
N
Moved to
Pending
N
First Enrollment as Active
Figure 3
Track
Improve
Employ
Using these
can address
cies of the rapidly evolving specialtypharmacy landscape, and rest assured that
the processes surrounding specialty treatments
are efficient, secure and patient-centered.
Product
Fulfillment
Actions
Challenges
Financial
Assistance
Actions
Challenges
Treatment
Initiation
Actions
Figure 4
Quick Take
Performing a Patient Flow Analysis
Business Situation/Challenge
The Benefits
The Solution
77
Footnotes
1
Ibid.
Ibid.
2013 Drug Trend Report Highlights, The Express Scripts Lab, April 8, 2014. http://lab.express-scripts.
com/~/media/pdfs/drug%20trend%20report/express%20scripts%202013%20drug%20trend%20
report%20highlights%20online.ashx.
Ibid.
Ibid.
Ibid.
Ibid.
10
Ibid.
11
Ibid.
References
http://www.pharmacist.com/specialty-pharmacy
http://drugchannelsinstitute.com/files/2014-15-PharmacyIndustry-Overview.pdf
http://www.pm360online.com/why-specialty-pharmacy-management-cant-be-ignored/
http://lab.express-scripts.com/~/media/PDFs/Drug Trend Report/ExpressScripts_DrugTrendReport.ashx
Specialty Pharmaceuticals - SCIO Health Analytics PDF (www.sciohealthanalytics.com )
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